<html><head>
    <title>Test</title>
    <meta content="">
    <style>body {line-height: 1.4} label {width: 200px;} input {width: 250px;}</style>
  </head>
  <body>
<label for="name">First Name: </label><input type="text" id="name" name="firstname"><br>
<label for="surname">Last Name: </label><input type="text" id="surname" name="lastname"><br>
<label for="e-mail">E-mail: </label><input type="text" id="e-mail" name="e-mail"><br>
<label for="phone">Phone: </label><input type="text" id="phone" name="phone"><br>
<label for="mobilephone">Mobile: </label><input type="text" id="mobilephone" name="mobilephone"><br>
<label for="homepage">Website: </label><input type="text" id="homepage" name="homepage"><br>
<label for="address">Address: </label><input type="text" id="address" name="address"><br>
<label for="city">City: </label><input type="text" id="city" name="city" style=""><br>
<label for="zip">Postal code: </label><input type="text" id="zip" name="zip"><br>
<label for="country">Country: </label><input type="text" id="country" name="country"><br>
<label for="state">State/Region: </label><input type="text" id="state" name="state"><br>

</body></html>
